Windhaven Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

APP #08498 Issued in TX

Legal business name

WINDHAVEN SURGERY CENTER, LLC

Practice address

6160 Windhaven Pkwy
Ste 220
Plano, TX 75093

Phone

(214) 707-0985

Fax

(888) 525-3558

NPI assigned

May 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Donna Drerup

Title

Chief Manager

Phone

(817) 875-7336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Windhaven Surgery CenterCCN 45C0001468

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1356542419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 WINDHAVEN PKWY",
            "address_2": "STE 220",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-707-0985",
            "fax_number": "888-525-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 WINDHAVEN PKWY",
            "address_2": "STE 220",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-707-0985",
            "fax_number": "888-525-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAVEN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "DRERUP",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "817-875-7336",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "APP #08498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter John Wiltse, D.O.
• Win With Wellness,LLC
• Windhaven Adolescent Medicine
• Windhaven Medical Imaging.LLC
• Windhaven Pediatrics, LLP
• Kevin Merle Windisch, MD
• Karis Windle Carmona, LCSW
• Jacqueline Renee Windle, PT
• Alyssa L Windom, AUD
• Winds Dialysis LLC (West Plano Dialysis)

• Ambulatory Surgical Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.